Individual
MS. MIA CONCORDIA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW, LICSW
Contact information
Practice address
16045 1ST AVE S FL 1, BURIEN, WA 98148-1401
(206) 965-4100
(206) 965-4119
Mailing address
16045 1ST AVE S, FL 1, BURIEN, WA 98148-1401
(206) 965-4100
(206) 965-4119
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
LW61076495
WA
1041C0700X
Clinical Social Worker
Primary
LW61076495
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2165261
—
WA
Enumeration date
08/11/2015
Last updated
10/02/2024
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